An oncologist explains what could be the factors contributing to the rise of childhood cancer cases in India, and what can be done about it - from recognising the symptoms to finding ways to prevent it.

Key Highlights

Childhood cancer is also the ninth common cause of death for children between 5 to 14 years of age in India

Each year, as many as 50,000 children and adolescents ages 0 to 19 years will be diagnosed with cancer in India

An oncologist tells us what could be the factors driving the rise of childhood cancer cases in India and what can be done about it

New Delhi: A cancer diagnosis at any age can come as a shock, but when the patient is a child it can be even more shocking - especially for parents who often have trouble believing that this is happening. Despite favourable prognosis and the chances of being cured continuing to improve, dealing with a diagnosis of cancer in a child can be extremely overwhelming. India figures among the countries with the highest burden of childhood cancer in the world, as shown in a recent report.

The report published in the journal The Lancet Oncology showed that about 700 children in the world are diagnosed with cancer every year. Worldwide, childhood cancer was the sixth leading cause of total cancer burden and the ninth leading cause of childhood disease burden. Childhood cancer is also the ninth common cause of death in children between 5 to 14 years of age in India. The Indian Cancer Society estimates that each year, as many as 50,000 children and adolescents ages 0 to 19 years will be diagnosed with cancer in India.

In an exclusive interview with Salome Phelamei of Times Now Digital, Dr Tejinder Kataria, chairperson, Radiation Oncology, Cancer Institute, Medanta, The Medicity, explains what could be the factors driving the rise of childhood cancer cases in India, and what can be done about it - from recognising the symptoms and the importance of getting the right treatment to finding ways to prevent the disease.

Below are excerpts from the interview.

(Dr Tejinder Kataria)

Salome: Are there any warning signs of childhood cancer?

Dr Tejinder Kataria: The warning signs of childhood cancer can be -

Fatigue, lack of energy, loss of interest and lack of playfulness.

Easy bruising or painless bleeding from gums.

Pain in any part of the body that becomes worse at night.

Difficulty in walking.

An unusual lump or swelling.

Unexplained fever for more than 2 weeks.

Frequent headache, vomiting or vision changes.

Salome: What do you think are the factors contributing to the rise of cancer, particularly childhood cancer, in our country?

Dr Tejinder Kataria: The drivers of cancers in India are carcinogenic pollutants in atmosphere and water.

Atmospheric pollutants include carbon monoxide, benzene, dioxins, 1,3-butadiene, lead and Benzo(a) pyrene. The attributable risk with these carcinogens is highest within one km of the hotspot or source of emission and is linked to acute leukaemia or blood cancer. There are four main sources of atmospheric pollution -

Water pollutants come in different forms such as industrial waste and sewage. Industrial pollutants include - burning fossil fuel (like oil, natural gas, coal and petroleum), chemicals used in dyeing and tanning industry, untreated gas and the liquid waste being released into the environment, improper disposal of radioactive material.

The untreated effluents containing chemicals, heavy metals, organic waste and radioactive waste if discharged into city sewerage or natural water bodies contaminate the soil and the food chain. The fact is that crops, trees, fish, poultry and birds partake this contaminated water and human beings absorb them through the food.

Although large scale studies are lacking in India, the Childhood Leukaemia International Consortium (CLIC) found an increased risk of childhood leukaemia in parents exposed to pesticides.

Salome: So, what can be done to tackle the increasing burden of cancer cases in India?

Dr Tejinder Kataria: The choices we make on an everyday basis can help us find a solution to overcome a few of the risk factors.

Use a fuel-efficient vehicle when you make a choice.

Save energy by turning off electrical appliances like television, air-conditioners, switch off the light when not needed. This will reduce your electricity bill and you will reduce the emission from coal-fired and electricity plants.

Do not throw chemical and fertilisers in the drain water to prevent contamination.

At a strategic level, we need to implement -

Clean fuel policies.

Pesticide-resistant varieties of foods rather than using pesticides (organic farming).

To treat the industrial effluents and chemicals before discharging in water bodies.

To improve the air quality, increase the use of solar energy and reduce dependence on fossil fuels.

Find an alternative solution for destroying the dry vegetation and after crop stubble rather than burning.

Salome: What are the most common childhood cancers in India?

Dr Tejinder Kataria: According to the National Cancer Registry data, the most common cancer amongst children in India is acute leukaemia followed by brain tumours and bone tumours like Ewing’s sarcoma.

Salome: How is childhood cancer treated and how long is the treatment?

Dr Tejinder Kataria: Over the last two decades, standardised protocols have been developed for the treatment of childhood cancers. For instance, the mainstay of treatment for acute leukaemia is chemotherapy, followed by a bone marrow transplant. A few children may need Total Body Irradiation (TBI) as a priming therapy before bone marrow transplant. For brain tumours and bone tumours, surgical decompression followed by radiation is recommended. Some children may need chemotherapy for bone tumours. In childhood, chemotherapy forms an important section of treatment along with radiation or surgery as an adjunct.

The duration of treatment for leukaemia and bone tumours can vary from 12-18 months, and for brain tumours from 2 months till 2 years.

Salome: What is the prognosis of childhood cancer?

Dr Tejinder Kataria: Childhood cancers have a very good prognosis when treated in dedicated centres. The cure rates are more than 85% for acute lymphatic leukaemia, 80% in Medulloblastomas (a type of brain tumour) and 65% in bone tumours at 5 years. These young children grow up into exceptionally intelligent adults and a large proportion can have almost normal life spans.

Salome: How well equipped is India’s healthcare industry in cancer care?

Dr Tejinder Kataria: There are approximately 60 dedicated childhood cancer centres in India and about 100 practising pediatric oncologists. Amongst the medical colleges, 100 colleges offer pediatric cancer treatment besides the dedicated centres. There is one functional Proton Therapy Centre in the country and about 350 Megavoltage radiation units to deliver the state-of-the-art radiotherapy to children with cancer.

[INTERVIEW] Rise of childhood cancer in India: Symptoms, treatment, prognosis and preventionDescription:An oncologist explains what could be the factors contributing to the rise of childhood cancer cases in India, and what can be done about it - from recognising the symptoms to finding ways to prevent it.Salome Phelamei